hsph conference program 11/2010

TRANSFORMING EDUCATION TO STRENGTHEN HEALTH SYSTEMS IN AN INTERDEPENDENT WORLD

Health Professionals for a New Century


November 30 - December 1, 2010

LAUNCH OF THE REPORT

OF THE COMMISSION ON EDUCATION OF

HEALTH PROFESSIONALS FOR THE 21ST CENTURY

HPNC.prg11.22_Layout 1 11/22/10 1:18 PM

HEALTH PROFESSIONALS FOR A NEW CENTURY

Welcome Julio Frenk

One hundred years ago a series of reports transformed theeducation of health professionals. Starting with the FlexnerReport in 1910, these reports sparked an enormous burst of

energy that harnessed the power of science to revamp and improve highereducation in the health field. As we close a year of centennial celebrationsof the Flexner Report, we recommend what we hope is a new generationof reforms to meet the demands of an interdependent world.

Building on a rich legacy, we launch our report— “Health Professionalsfor a New Century: Transforming Education for Health Systems in anInterdependent World”—published in The Lancet. In the course of thisyear, there have been many other inspirational reports and valuablediscussions about the need for a new wave of reform. To these we add our

voice—more global in nature and inter-professional. We also take a systems approach to analyzing theentire health and education enterprise, rather than focusing on single institutions. Our Commission on the Education of Health Professionals for the 21st Century comprisesillustrious educational leaders from diverse countries, who worked diligently over the past year toarticulate a vision and recommend actions. The idea came from a series of conversations with LincolnChen, my co-chair for the Commission, Harvey Fineberg, from the Institute of Medicine, and JaimeSepulveda and Kathy Cahill from the Bill & Melinda Gates Foundation.In addition to commissioners and the members of the several advisory groups, I would like to thankthe President of Global Health at Gates, Tachi Yamada, and from the Rockefeller Foundation, JudithRodin and Ariel Pablos-Méndez. Without them and our other sponsors, the China Medical Board andThe Lancet, this ambitious undertaking would not have been possible.What really made the reports of the early 20th century so important, of course, was the follow-up ontheir recommendations. We hope that this symposium and your contributions in the panel discussionswill generate sustained follow-up to further refine and implement our recommendations in multiplesites around the world.A strong image in our report is the idea of three generations of reform. Just like human generationswith grandparents, parents and children, we take valuable elements from each generation and buildon their legacies. This report focuses on change, but also continuity, as we chart a new direction basedon the interdependence of nations and the power of transformative learning.

Julio Frenk, MD, MPH, PhDLaunch Co-Chair; Commission Co-ChairDean of the Faculty, Harvard School of Public HealthT & G Angelopoulos Professor of Public Health and International Development, Harvard School of Public Health and Harvard Kennedy School


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When co-chair, Julio Frenk, originated the idea of a “Flexner-21,”on the centennial year of the 1910 Flexner Report, I had mixedreactions. On the one hand, a revisit in today’s context was

timely and necessary given the transformative impact of the originalReport. On the other hand, the challenge was truly daunting, and I hadpersonally mixed feelings about both the positive and negative aspects ofthe Flexnerian revolution. Flexner rode on the wave of the discovery of thegerm theory that catalyzed the explosive growth of the modern medicalsciences. What characterizes the major forces of our era?

The China Medical Board had a special stake in a new Flexner-21.Established in 1914, the CMB was the second major program of thenewly-created Rockefeller Foundation, which over several decades

invested in the “Flexner model” around the world, especially in China. The Flexner brothers,Abraham and Simon, were key Board members of the Rockefeller philanthropies, and CMB waslaunched to create the Peking Union Medical College in China. To this day, the PUMC has followed aFlexnerian curriculum of eight years of post-high school professional education in China—outlastingthe Japanese invasion, World War II, Mao’s revolution, and the recent economic resurgence.Moreover, a Commission to revisit Flexner would help inform CMB’s work for its second century.This time, however, the research, consultation, visits, and development would be conducted by aremarkably talented group of 20 Commissioners backed by the willingness of The Lancet to considerpublication of the Report after peer review.Constrained by time and budget, this Commission’s journey has been extraordinarily rich. Ourreward is the quality of the collective interactions for achieving our aspiration, not necessarily forwholesale adoption of our Report recommendations, but most importantly for sparking dialogue anddebate over a new century of reforms matched to our times.

Lincoln Chen, MDLaunch Co-Chair; Commission Co-ChairPresident, China Medical Board

Welcome Lincoln Chen


For most health workers in high-income countries, we have likely takenour professional education for granted. I certainly did. Whether it was anursing or medical school, or a school of public health, we may have seenour time there as little more than a routine stepping stone to what reallymattered—practice.

I now see the mistake I made in not taking the kind of education Ireceived more seriously. Worse, until I began taking part in the work ofthis Commission, I had not fully appreciated the central importance ofthe health professional education system to the overall goals of thehealth system. The Commission report we have the privilege ofpublishing today—the first of its kind in my generation—attempts tocorrect that systemic neglect.

The Millennium Development Goals (MDGs) have been an astonishingly powerful instrument toset a political, technical, and even moral course towards a fairer world. Quite rightly, they have triedto make connections—between poverty and gender, governance and the environment, andeducation and health. But one inadvertent adverse effect of the MDGs is that the place of tertiaryeducation has been forgotten. While primary and secondary education have rightly been given acritical place in our understanding of human development, professional education has been erasedfrom the development agenda.In retrospect, this was a grave error. In some countries, the government education budget hasfocused on primary and secondary education, taking money away from higher education. This policymay have hastened outward migration and slowed the development of those health professionscrucial to resolving the health predicaments of the country.No single Commission report can, on its own, reverse decades of neglect. But it can act as acatalyst to accelerate our understanding of the needs of nations facing multiple disease emergencies.My hope is that this Commission, so ably chaired by Julio Frenk and Lincoln Chen, can begin thatprocess. It will be our shared responsibility to ensure that their call to action is heeded.

Richard Horton, MDLaunch Co-Chair; CommissionerEditor-in-Chief, The Lancet


Welcome Richard Horton


Hosts: Harvard School of Public Health, China Medical Board, and The Lancet with support from The Bill & Melinda Gates Foundation, The Rockefeller Foundation, and China Medical Board

Joseph B. Martin Conference Center at Harvard Medical School77 Avenue Louis Pasteur, Boston, MA 02115November 30, 2010: 8:30 AM–8:00 PM and December 1, 2010: 8:15 AM–1:00 PM

The Commission Report, “Health Professionals for a New Century,” will be published by TheLancet at the end of November 2010. To mark its public release on the centenary of the 1910 FlexnerReport, the Commission Report will constitute the focus of a Launch celebration hosted by theHarvard School of Public Health. The purpose of the event, consisting of four interactive panels, is topromote discussion, exchange, and even debate about the Commission’s findings andrecommendations.The full Commission Report and its Executive Summary will be made available to all Launchparticipants. The Report adopts a global perspective on the education for the major healthprofessions following a systems framework that considers the education and health sectors focusingon institutional and instructional reforms. The Report concludes by recommending adoption of athird generation of systems-based reforms of instruction and education, based on transformativelearning and interdependence in education for advancing equity in health around the world.Biographical information about the Commissioners, Speakers and Panelists may be found in theback section of this booklet.

DAY ONE AGENDA, November 30Registration and light breakfast8:30–9:00 a.m., Ground Floor Lobby

Welcome Remarks9:00–9:45 a.m., Auditorium

Speakers: Provost Steven Hyman, Harvard UniversityDean Jeffrey Flier, Harvard Medical SchoolDr. Margaret Chan, World Health Organization (video message)Ms. Irina Bokova, UNESCO (video message)Ms. Cheryl Scott, The Bill & Melinda Gates FoundationDr. Ariel Pablos-Méndez, The Rockefeller Foundation

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Health Professionals for a New Century



Report Presentation9:45–11:00 a.m., Auditorium

Speakers: Dr. Richard Horton, The Lancet Dr. Lincoln Chen, China Medical BoardDean Julio Frenk, Harvard School of Public Health

Break11:00–11:30 a.m.

Discussion11:30 a.m.–12:30 p.m., Auditorium

Lunch12:30–1:30 p.m., Ground Floor Lobby and 1st Floor Lounge

Panel 1 – Transforming the Learning Process1:30–3:00 p.m., Auditorium

Transformative learning is the highest of three successive levels, moving from informative toformative to transformative learning. Informative learning is about acquiring knowledge and skills;its purpose is to produce experts. Formative learning is about socializing students around values; itspurpose is to produce professionals. Transformative learning is about developing leadershipattributes; its purpose is to produce enlightened change agents. Effective education builds each levelupon the previous one.

Chair: Dr. David Naylor, University of TorontoPanelists: Dean David Serwadda, Makerere University of Public Health

Dean Afaf Meleis, University of Pennsylvania School of Nursing Dr. Joseph Kolars, University of Michigan

Break3:00–3:30 p.m.

Panel 2 – Reforming Educational Institutions3:30–5:00 p.m., Auditorium

Interdependence is a key element in a systems approach as it underscores the ways in which variouscomponents interact with each other. As a desirable outcome, interdependence in education alsoinvolves three fundamental shifts: from isolated to harmonized education and health systems; fromstand-alone institutions to networks, alliances, and consortia; and from inward-looking institutionalpre-occupations to harnessing global flows of educational content, pedagogical resources, andinnovations.


Conference Agenda


Chair: Dr. Huda Zurayk, University of BeirutPanelists: Dr. Jordan Cohen, George Washington University

Dr. Jane Henney, University of Cincinatti College of MedicineDr. Susan Scrimshaw, The Sage Colleges

Reception5:00–6:00 p.m., Ground Floor Lobby

Celebratory Dinner6:00–8:00 p.m., Elements, 2nd floor

Speaker: Dr. Samuel Thier, Harvard Medical School, Partners Healthcare

DAY TWO AGENDA, December 1 Light Breakfast, Registration*8:15–8:45 a.m., Ground Floor Lobby

Panel 3 – Local Adaptability in a Global World8:45–10:15 a.m., Auditorium

For these educational reforms to help achieve equity in health, a series of enabling actions will berequired: First, broad engagement of leaders at all levels—local, national, and global—will be criticalto achieve the proposed reforms and outcomes. Leadership must come from within the academicand professional communities, but it must be backed by political leaders in government and society.Second, current funding shortfalls must be overcome with a substantial expansion of investments inhealth professional education from all sources: public, private, development aid, and foundations.Third, stewardship mechanisms, including socially-accountable accreditation, should bestrengthened to assure optimal results for any given level of funding. Lastly, there is thestrengthening of shared learning supported by metrics, evaluation, and research to build theknowledge base about which innovations work under certain circumstances.

Chair: Lord Nigel Crisp, House of LordsPanelists: Dr. Timothy Evans, World Health Organization

Dr. Patricia Garcia, Cayetano Heredia University, PeruDr. Barry Kistnasamy, National Institute for Occupational Health

Break10:15–10:45 a.m.

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* Registration required only for those unable to attend on November 30.


Panel 4 – Strategies for Dissemination10:45 a.m.–12:30 p.m., Auditorium

Health professionals have made enormous contributions to health and development over the lastcentury, but complacency will only perpetuate the ineffective application of 20th century educationalstrategies unfit to tackle 21st century challenges. Therefore, we call for a global social movementinvolving all stakeholders—educators, students and young health workers, professional bodies,universities, non-governmental organizations, international agencies, donors, and foundations—that can propel action on this vision and these recommendations to promote a new century oftransformative professional education. The result will be more equitable and better performinghealth systems with consequent benefits for patients and populations everywhere in ourinterdependent world.

Chair: Dr. Harvey Fineberg, US Institute of MedicinePanelists: Dr. Manuel Dayrit, World Health Organization

Dr. George Thibault, Josiah Macy, Jr. FoundationDr. Sigrun Møgedal, Global Health Workforce Alliance, UNAIDSDr. Roger Glass, NIH Fogarty CenterDr. Ariel Pablos-Méndez, The Rockefeller Foundation

Follow-up and Closing Remarks 12:30–1:00 p.m., Auditorium

Speakers: Dean Julio Frenk, Harvard School of Public Health Dr. Lincoln Chen, China Medical Board

Panelists and Agenda reflected as of November 12, 2010.


Conference Agenda


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Organizers

Supporters


New Contexts – New ChallengesHealth is all about people. Beyond the glitteringsurface of modern technology, the core space ofevery health system is occupied by the uniqueencounter between one set of people who needservices and another who have been entrustedto deliver those services. That trust is earnedthrough a special blend of technical competenceand service orientation, steered by ethicalcommitment and social accountability, whichforms the core of professional work.Developing such a blend requires a prolongedperiod of education and a substantialinvestment on the part of both student andsociety. Through a chain of events flowing fromeffective learning to high-quality services toimproved health, professional education at itsbest makes an essential contribution to thewell-being of individuals, families, andcommunities. Yet, the context of and demands on theeducation of health professionals are rapidlychanging across time and space. Lookingbackward, dramatic educational reforms onecentury ago helped to spark unprecedentedhealth gains around the world. Good health,after all, is knowledge-based and socially-driven. The health professional plays a criticalmediating role as “knowledge broker,” linkingpeople to technology and information; asservice provider and care-giver; ascommunicator and educator; and as team

member, manager, leader, and policy-maker. Assuch, the health worker is the human face of thehealth system.But not all is well. By the opening of the 21stcentury, glaring gaps and striking inequities inhealth have been exposed, both within andacross countries. For those left behind, thedramatic advances in health and health care inricher countries are simply an indictment of ourcollective failure to ensure the equitable sharingof good health in a polarized world. At thesame time, the health security of all is beingchallenged by new infectious, environmental,and behavioral threats superimposed uponrapid epidemiologic and demographictransitions. Health systems are struggling tokeep up as they become more complex andcostly, placing fresh demands on healthworkers. Growing global interdependence hasintensified these health challenges byaccelerating the flow of diseases, technology,knowledge, financing, trade in health-relatedservices, and international migration ofprofessionals and patients.Professional education has not been immunefrom these dynamics. Indeed, there is a slow-burning crisis in the mismatch betweenprofessional competencies and patient andpopulation priorities due to narrowly-conceived, out-dated and static curriculaproducing ill-equipped graduates from under-financed institutions. Complacency will


Executive Summary

TRANSFORMATIVE LEARNING FOR A NEW CENTURY:INTERDEPENDENCE IN THE EDUCATION OF HEALTH PROFESSIONALS


perpetuate the inflexible application of 20thcentury educational strategies to tackle 21stcentury challenges. The failings are systemic—professionals unable to keep pace, becomingmere technology managers, and exacerbatingprotracted problems such as a reluctance toserve marginalized rural communities. Severalwell-meaning recent efforts have attempted toaddress these fractures, but they have mostlyfloundered for several reasons including therigidity and “tribalism” that afflict the healthprofessions.What is clearly needed is a full andauthoritative re-examination of thehealth professional education systemthat matches the ambitions of reformsa century ago. Review and re-designare especially timely not only becauseof changing contexts but also becauseof fresh opportunities ushered in byglobal interdependence and the sharedaspiration of the universal right to health.

The CommissionThese are the reasons why our Commission hasembraced the mission of advancing health, bothindividual and population-based, throughlandscaping instructional and institutionalinnovations in professional education to preparethe next generation for addressing new healthchallenges. We, the Commissioners, areprofessional leaders from diverse countries whohave worked to develop a common approach topost-secondary education beyond the confinesof national borders and the silos of individualprofessions. We adopted an inclusive approachto the health professions, but due to data andtime limitations, we concentrated on medicine,nursing-midwifery, and public health.We call for a new era of professional educationthat advances transformative learning andharnesses the power of interdependence ineducation. Just as reforms in the early 20thcentury rode on the wave of the germ theory and the establishment of modern medicalsciences, so too our Commission believes that

the future will be shaped by adaptation of corecompetencies to specific contexts drawing uponthe power of global flows of knowledge. Ourvision is global not parochial; multi-professionalnot confined to a single group; committed tobuilding sound evidence; encompassing bothindividual and population-based approaches;and focused on instructional and institutionalreforms. We believe that all health professionals in allcountries should be educated to lead in thecapacity to mobilize knowledge, as well as in

critical reasoning and ethical conduct, so theycan participate in patient- and population-centered health systems as members of locallyresponsive and globally connected teams. Theultimate purpose is to deliver high-qualitycomprehensive services for advancing theuniversal right to the highest attainablestandard of health. This vision is guided by twonotions:

Transformative learning captures the imperativeof generating purposeful change of: (i) studentsthrough the learning process; (ii) classroom-to-practice learning continuum; (iii) educationalinstitutions through reform; and (iv) socialreality through the action of competent andcommitted professionals.

Interdependence in professional educationunderscores interactions that harmonize six keylinkages among: (i) the local and global spheresof action; (ii) the health and education systems;(iii) health professionals and the people theyserve; (iv) all members of the health workforcefor inter- and trans-professional collaboration;(v) competencies shaped by context; and (vi)teachers and learners together.

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What is clearly needed is a full and authoritative re-examination of the health professionaleducation system that matches the ambitions ofreforms a century ago.



Framework and FindingsWe employ a systems approach to bringtogether the spheres of education and health,and we open the “black box” of the educationalsystem to examine both instructional andinstitutional design. Our framework is centeredon people as co-producers and as drivers ofneeds and demands in both education andhealth. Interacting through the labor market,the provision of educational services generatesthe supply of an educated workforce to meetthe demand for professionals to work in thehealth system. To impact on health outcomes,the professional education subsystem must

design instructional and institutional strategies.Instructional innovations. A total of 75 caseswere identified through a systematic search.For illustrative purposes, 25 are mappedhighlighting the participation of all worldregions and all major professions. Innovations were classified into threegenerations of reform. Educational reforms inthe 20th century share roots going back to socialand scientific developments in the 19th century.The first generation was sparked by threeseminal reports—Flexner (1910), Welch-Rose(1915), and Goldmark (1923)—which integratedmodern sciences into university-based schoolsof medicine, public health, and nursing,respectively. The second phase, around mid-20th century and included problem-basedlearning and integrated curricula accompaniedby growth of hospitals as academic centers. Themore recent third generation has emphasizedpatient and population centeredness,competency-driven curricula, inter-professionaland team-based education, IT-empoweredlearning, and leadership skills. Despite these reforms, dozens of recent reports, task forces,

commissions, and committees in severalcountries have underscored global workforceshortages, biased skill mix, mal-distributionwithin and across countries, and misalignmentof competencies to health priorities.We analyzed the instructional process in acomprehensive manner, from admissionsthrough graduation into professional careers.Overall, we concluded that instructionalinnovation, global in scope, is proceeding, albeitunevenly and slowly. Although someexperience has been accumulated, the field stillmostly lacks hard evidence. Recent reformmovements offer a base to build on—from the

mobilization of an appropriateworkforce to a re-focus oncompetencies driving curriculumdevelopment for team workstrengthened by IT—all with thepurpose of aligning education tohealth goals across national

borders and individual professions in allcountries.

Institutional landscaping was undertaken wheredata permitted in medicine, nursing, and publichealth. Altogether, we tabulated 2,420 medicalschools and 467 schools or departments ofpublic health and a global output of about onemillion newly trained doctors, nurses-midwives,and public health professionals each year.Educational institutions are highlydifferentiated and severely mal-distributed.Average class size, for example, varied between100 students in India to 1,000 in China. Fourcountries—China, India, Brazil, and USA—eachhaving more than 150 medical schools,constituted 35% of the global total. Thirty-sixcountries had no medical schools, and 26countries in sub-Saharan Africa have one or noschools. Medical school density per capitademonstrated robustness in Latin America,Western Europe, North Africa/Middle East andAustralia, but sparseness in sub-Saharan Africaand parts of Southeast Asia. Not surprisingly,medical school numbers did not align well witheither country population size or nationalburden of disease.


Executive Summary

We call for a new era of professional education thatadvances transformative learning and harnessesthe power of interdependence in education.


Total expenditures in health professionaleducation were estimated at around $100 billion($43.6 billion for medicine, $24.7 billion fornursing, and the remainder assumed for otherhealth professionals). The average cost permedical graduate was $113,000 and per nursinggraduate $46,000. Unit costs were highest inNorth America and lowest in China.Noteworthy were the small share of studenttuition fees to school revenue and the recentexplosive growth of private schools in countriessuch as Brazil and India.Accreditation is a key stewardship functionbut is unevenly practiced around the world. Thechallenge is to balance local practice with globalstandards in aligning its purposes with healthand societal goals. Skill mix and labor marketsunderscore how poorer countries mustharmonize professional with basic healthworkers to form effective teams and how richercountries must introduce global perspectivesinto their domestic programs, while payingattention to the education of up to one-quarterof their professional workforce which isimported after overseas training. Interdependence creates both the need andthe potential for an expansion of collaborationthrough global networks and consortia that willharness resources and enhance shared learningacross countries.Overall, there is a severe global shortage ofinstitutions devoted to health professionaleducation, exacerbated by marked mal-distribution both across and within countries.Financing is very weak for professionaleducation and funding for R&D is inferred to beexceptionally low. The explosive growth ofprivate schools, as in Brazil and India, poses thechallenge of a “de-Flexnerization” process with the multiplication of low qualityproprietary schools of the type that were closed a century ago.

Reforms for the 21st CenturyAll peoples are tied together in an increasinglyinterdependent global health space. While eachcountry must address national problemsthrough building its own workforce, there is aglobal pool of talent. Cross-border flows ofprofessionals, patients, and services are growingand impacting on educational content,channels, and competencies in all countries.Each profession may have a distinctive set ofskills, but there is the imperative for bringingsuch expertise together into teams for effectivepatient-centered and population-based healthwork in diverse and rapidly changing contexts.Like porous borders, the walls betweenfunctional competencies by professions are notairtight but assume various shades of greywhere “task-shifting” and “task-sharing” arecrafted to produce practical health outputs thatwould not be possible with impermeableprofessional silos.We call for a new era of professional educationthat advances transformative learning andharnesses the power of interdependence ineducation. Our two guiding notions lead tospecific reforms and actions.

Instructional reforms – should be driven by acompetency-based approach crafting curriculumand learning channels as instruments to matchlocal conditions while harnessing globalresources; the set of competencies that definedistinctive professions should be constantlyreviewed and re-aligned to reflect changingcontexts.

Institutional reforms – are urgently needed tostrengthen weak stewardship of organizationsand systems through joint education-healthsector planning, expanding academic systemsinto clinics and communities locally andglobally, developing collaborative networks formutual strengthening, and promoting theculture of critical inquiry and public reasoning.

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Enabling Actions – are critical for overcomingbarriers to reform. We propose immediate andlonger-term actions to:Mobilize leadership in the academic andprofessional communities backed by politicalleaders in government and civil society,specifically philanthropic leadership whichcatalyzed reforms one century ago and has theopportunity to do so again; ministerial summitssponsored by WHO and UNESCO; andnational academic forums engaging allstakeholders.

Enhance investments, which now approximate$100 billion annually for professional educationin a $5.5 trillion global healthcare industry.Only 2% of expenditure devoted to humancapability enhancement for a labor- and talent-intensive industry is plainly insufficient,imbalanced, and unwise. Given this huge gap,every country and agency should considerdoubling its investments over the next fiveyears. Public financing should seek to aligncompetencies and skill mix, while reducingwaste and re-structuring incentives forperformance; donor funding must be sharplyincreased; and private financing should beenhanced but guided by policies to optimizehealth while minimizing the hazards ofunregulated, un-accredited, and low qualityschools.Align accreditation with societal health goalsthrough engaging relevant stakeholders insetting objectives, criteria, assessment, andtracking of accreditation processes at both thenational and global levels.

Strengthen global learning systems that areweak because the funding for R&D in this fieldis shockingly meager. Overcoming lethargy andlow vitality could be addressed by metrics,evaluation, and research to build a knowledgebase for continuous improvement.At this critical time upon the centenary ofmajor reforms, we invite all concernedstakeholders to join us in much neededrethinking for transforming professionaleducation in the 21st century. Healthprofessionals have made huge contributions to

health and happiness over the lastcentury, but we cannot fight 21stcentury health battles with out-dated, inappropriate, or inadequatecompetencies. The extraordinarypace of global change is stretchingthe core competencies of all the

health professions. That is why we call for thisnew round of more agile and rapid adaptationof competencies based on trans-national, multi-professional, and long-term perspectives toserve the needs of individuals and populations. Ultimately, however, reform must begin with achange in the mindset that acknowledgesproblems and seeks to solve them. Effectiveimplementation will require a global socialmovement engaging all stakeholders as part ofa concerted effort to strengthen health systems.The result would be an enlightened newprofessionalism that can lead to better servicesand consequent improvements in the health ofpatients and populations. In this way,professional education would become a crucialcomponent in the shared effort to address thedaunting health challenges of our times, andthe world would move closer to a new era ofpassionate, participatory, and people-centeredaction to progressively realize the right to thehighest attainable standard of health for all.


Executive Summary

Effective implementation will require a globalsocial movement engaging all stakeholders as partof a concerted effort to strengthen health systems.


Julio Frenk, MD, MPH, PhD, is Deanand T & G AngelopoulosProfessor of Public Health andInternational Development at theHarvard School of Public Health,appointed in January 2009. Dr.Frenk was the Minister of Healthof Mexico from 2000 to 2006,

where he pursued an ambitious agenda toreform the nation’s health system, with anemphasis on redressing inequities, improvinghealth, and extending financial protection. He isperhaps best known for his work in introducinga program of comprehensive national healthinsurance, known as Seguro Popular, whichexpanded access to health care for tens ofmillions of previously uninsured Mexicans. Dr.Frenk was also the founding Director-Generalof the National Institute of Public Health inMexico. From 1998-2000, he was ExecutiveDirector in charge of Evidence and Informationfor Policy for the World Health Organization.Most recently, he was a Senior Fellow in theglobal health program of the Bill & MelindaGates Foundation and President of the CarsoHealth Institute in Mexico City. Dr. Frenk holdsa medical degree from the NationalAutonomous University of Mexico, as well asthree advanced degrees from the University ofMichigan: master of public health, master of artsin sociology, and a PhD in medical organizationand sociology. In 2008, he received the ClintonGlobal Citizen Award for changing “the waypractitioners and policy makers across the worldthink about health.”Co-Chair, Commissioner on the Education of Health Professionals for the 21st Century

Lincoln Chen, MD, MPH, isPresident of the China MedicalBoard (CMB), an independentAmerican foundation endowed byJohn D. Rockefeller to advancehealth in China and Asia bystrengthening medical education,research and policies. Dr. Chen

was the Founding Director of the HarvardGlobal Equity Initiative (2001-2006) and from1987-1996, the Taro Takemi Professor ofInternational Health and Director of theUniversity-wide Harvard Center for Populationand Development Studies. From 1997-2001, hewas Executive Vice-President of the RockefellerFoundation, and earlier for 14 years, representedthe Ford Foundation in India and Bangladesh.Dr. Chen serves on the board of manyorganizations, including BRAC USA, FXBCenter on Health and Human Rights atHarvard, Social Science Research Council, theInstitute of Metrics and Evaluation at theUniversity of Washington, and the Public HealthFoundation of India. He graduated fromPrinceton University (BA), Harvard MedicalSchool (MD), and the Johns Hopkins School ofHygiene and Public Health (MPH).Co-Chair, Commissioner on the Education of Health Professionals for the 21st Century

Richard Horton, FRCP, FMedSci, isEditor-in-Chief of The Lancet. Hewas born in London and is halfNorwegian. He qualified inphysiology and medicine from theUniversity of Birmingham in 1986.He joined The Lancet in 1990,moving to New York as North

American Editor in 1993. Dr. Horton was thefirst President of the World Association ofMedical Editors and is a Past-President of theUS Council of Science Editors. He is anhonorary professor at the London School ofHygiene and Tropical Medicine, UniversityCollege London, and the University of

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Launch Co-Chair Biographies


Edinburgh. He is a Council member of the UK’sAcademy of Medical Sciences and theUniversity of Birmingham, and he chairs theBoard of the Health Metrics Network. He has astrong interest in issues of global health andmedicine’s contribution to wider culture.Commissioner on the Education of HealthProfessionals for the 21st Century

Commissioners: Zulfiqar A. Bhutta, MB, BS, PhD, isHusein Laljee Dewraj Professorand head of the newly createdDivision of Maternal and ChildHealth of the Aga KhanUniversity Medical Center inKarachi, Pakistan. He also holdsadjunct professorships in

International Health & Family and CommunityMedicine in the departments of InternationalHealth at Boston University and TuftsUniversity. He was designated a DistinguishedNational Professor of the Government ofPakistan in 2007. Dr. Bhutta heads a largeresearch team working on issues of maternal,newborn and child survival and nutritionglobally and regionally. He is a past member ofthe World Health Organization AdvisoryCommittee for Health Research, the FoundationCouncil of the Global Forum for HealthResearch, and the executive committee of theInternational Paediatric Association. He is Co-Chair of the Countdown to 2015 initiative and aboard member of the Global Partnership forMaternal, Newborn and Child Health. He iscurrently the Chair of the Health SciencesGroup of the Biotechnology Commission ofPakistan, a member of the WHO StrategicAdvisory Committee for Vaccines, the AdvisoryCommittee for Health Research of WHOEMRO, and its apex Regional ConsultativeCommittee. Dr. Bhutta has won several awards,including the Tamgha-i-Imtiaz (Medal ofExcellence) by the President of Pakistan (2000)

and the inaugural award (2009) of the Programfor Global Pediatric Research for outstandingcontributions to Global Child Health andResearch.

Jordan J. Cohen, MD, is currentlyProfessor of Medicine and PublicHealth at George WashingtonUniversity and President Emeritusof the Association of AmericanMedical Colleges (AAMC). Duringhis 12 years as the AAMCPresident (1994-2006), Dr. Cohen

launched new initiatives for improving medicaleducation and clinical care in each of theassociation's mission areas of education,research and patient care. Prior to that, Dr.Cohen spent 40 years in academic medicine atsome of the nation's most prestigiousinstitutions. He was Dean of the medical schooland Professor of Medicine at the StateUniversity of New York at Stony Brook andPresident of the medical staff at UniversityHospital. Prior to that, he was Professor andAssociate Chairman of Medicine at theUniversity of Chicago-Pritzker School ofMedicine, and Physician-in-chief and Chairmanof the Department of Medicine at the MichaelReese Hospital and Medical Center. He has alsoheld medical faculty positions at Harvard,Brown, and Tufts universities. He is a formerchair of the American Board of InternalMedicine and of the Accreditation Council forGraduate Medical Education, and served asPresident of the Association of ProgramDirectors of Internal Medicine. Dr. Cohen is agraduate of Yale University and Harvard MedicalSchool and completed postgraduate training ininternal medicine on the Harvard service at theBoston City Hospital and a fellowship innephrology at the Tufts-New England MedicalCenter.


Commissioner Biographies


Nigel Crisp, KCB, is anindependent crossbench memberof the House of Lords and worksmainly on internationaldevelopment and global health.From 2000 to 2006, he was bothChief Executive of the NHS, thelargest health organization in the

world, and Permanent Secretary of the UKDepartment of Health, and led major reforms inthe English health system. His new bookTurning the world upside down - the search forglobal health in the 21st Century takes further theideas about mutual learning between rich andpoor countries that he developed in his 2007report for the Prime Minister—Global HealthPartnerships: the UK contribution to health indeveloping countries. He has a particular interestin human resources and global partnerships. In2007 he co-chaired an international Task Forceon increasing the education and training ofhealth workers globally and subsequentlyfounded the Zambia UK Health WorkforceAlliance in 2009 in order to implement some ofthe Task Force recommendations. He is amember of the Health Worker MigratoryAdvisory Council and a Champion Advocate forthe Global Health Workforce Alliance. NigelCrisp chairs Sightsavers International, is aSenior Fellow at the Institute for HealthcareImprovement, a Distinguished Visiting Fellow atthe Harvard School of Public Health, and anHonorary Professor at the London School ofHygiene and Tropical Medicine.

Timothy Evans, MD, DPhil, ofCanada, is currently the AssistantDirector-General for Information,Evidence and Research at theWorld Health Organization. From2003 to 2007, he served as theAssistant Director-General forEvidence and Information for

Policy. From 1997 to 2003, Dr. Evans wasDirector of Health Equity at the RockefellerFoundation. He has a Bachelor of SocialSciences from the University of Ottawa, a DPhil in Agricultural Economics from the

University of Oxford, as well as a Doctor ofMedicine from McMaster University in Canada.He trained in internal medicine at the Brighamand Women’s Hospital at Harvard Universityand was an assistant professor of internationalhealth economics at the Harvard School ofPublic Health.

Harvey V. Fineberg, MD, PhD, isPresident of the Institute ofMedicine. He previously servedHarvard University as Provost and13 years as Dean of the School ofPublic Health. He helped foundand served as President of theSociety for Medical Decision

Making and is a consultant to the World HealthOrganization. His research has includedassessment of medical technology, evaluation ofvaccines, and dissemination of medicalinnovations. At the Institute of Medicine, he haschaired and served on a number of panelsdealing with health policy issues, ranging fromAIDS to new medical technology. He also servedas a member of the Public Health Council ofMassachusetts (1976-1979), as Chairman of theHealth Care Technology Study Section of theNational Center for Health Services Research(1982-1985), and as President of the Associationof Schools of Public Health (1995-1996). He isthe author or co-author of numerous books andarticles on subjects ranging from AIDSprevention to medical education. Dr. Finebergholds four degrees from Harvard, including anMD and PhD in Public Policy.

Patricia Garcia, MD, MPH, isProfessor of the School of PublicHealth at Cayetano HerediaUniversity (UPCH) and formerChief of the Peruvian NationalInstitute of Health (2006-2008). Asa Chief of the National Institute ofHealth, Dr. Garcia implemented a

web-based laboratory information system(NETLAB), which is the first example of eHealthin Peru and was recognized as a best practice.Dr. Garcia graduated from medical school in

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Commissioner Biographiescontinued

Peru, and trained in internal medicine,infectious diseases, and public health at theUniversity of Washington. She has worked atthe National STD/AIDS Program in Peru (1997-1999), as Director of the Epidemiology, STD andHIV Unit at UPCH (1999-2010), and as ViceDean of Research at UPCH (1999-2005). Shehas been a member of the Senior TechnicalAdvisor Group of the Reproductive HealthDepartment at the World Health Organizationand Chair of the WHO HPV Expert AdvisoryGroup. Now she is the Regional Director, LatinAmerica, International Union Against STIs;Affiliate Professor of the Department of GlobalHealth, School of Public Health, University ofWashington; and Affiliate Professor of theSchool of Public Health at Tulane University.She is actively involved in research on STIs andHIV, global health, and informatics.

Patrick Kelley, MD, DrPH, isDirector of the Board on GlobalHealth and Director of the Boardon African Science AcademyDevelopment at the Institute ofMedicine of the U.S. NationalAcademies. Dr. Kelley oversaw aportfolio of expert consensus

studies and convening activities on subjectsincluding the evaluation of the U.S. emergencyplan for international AIDS relief (PEPFAR),methodological issues in the conduct of HIVprevention trials in developing countries, theevaluation of intermittent preventive therapy formalaria in infants, the need for retention of thevariola virus, and U.S. public and private sectorinterests in global health, and the prevention,treatment, and palliation of cancer in low andmiddle income countries. Prior to coming to theNational Academies in 2003, he served in theU.S. Army for more than 23 years as a physician,residency director, epidemiologist, and programmanager. Much of his work focused on diseasecontrol and policy for the Department ofDefense. Dr. Kelley obtained his MD from theUniversity of Virginia and his DrPH from theJohns Hopkins School of Hygiene and PublicHealth.

Barry Kistnasamy, MBChB, MMed,is Executive Director of theNational Institute forOccupational Health (NIOH) andthe National Cancer Registry(NCR) in South Africa, which arenational institutes within theNational Health Laboratory

Service. Dr. Kistnasamy was the former Dean ofMedicine of the Nelson R. Mandela School ofMedicine of the University of KwaZulu-Natal inDurban, South Africa and from 1995 to 2000was Deputy Director General of theDepartment of Health, Welfare andEnvironment in the Northern Cape province.His experience encompasses strategic andoperational planning and translation of healthpolicy into action. He has worked with bilateraland multilateral agencies in South Africa andabroad and has developed extensive nationaland international health partnerships andlinkages. Dr. Kistnasamy received his medicaldegree and master in medicine degree incommunity health from the University of Natal.He has had further education at York University(Health Economics), University of Michigan(Occupational and Environmental Health) andCambridge (Health Leadership). He has servedon many public, non-governmental and privatesector committees, including the Medical andDental Professions Board and the HealthSystems Trust.

Afaf I. Meleis, PhD, is the MargaretBond Simon Dean of Nursing atthe University of PennsylvaniaSchool of Nursing, Professor ofNursing and Sociology, andDirector of the school's WHOCollaborating Center for Nursingand Midwifery Leadership. Prior

to coming to Penn, she was a Professor on thefaculty at the University of California, LosAngeles and the University of California, SanFrancisco for 34 years. Dr. Meleis' researchfocuses on global health, immigrant andinternational health, women's health, and onthe theoretical development of the nursing


discipline. She is the author of more than 150journal articles, 40 chapters, and numerousmonographs, proceedings, and books aboutglobal issues in women’s health and thetheoretical bases of nursing. Her writing andconsultations are based on experiences andresearch in the Middle East and Latin America.She is a member of the Institute of Medicine, aFellow of the American Academy of Nursing, amember of the Forum of Executive Women, andthe Pennsylvania Women's Forum, a trustee ofthe National Health Museum, and a boarddirector of CARE. She is also President andCounsel General Emeriti of the InternationalCouncil on Women's Health Issues. Dr. Meleiscompleted her Bachelor of Science in Nursingdegree at the University of Alexandria, Egypt, amaster’s in nursing, a master’s in sociology anda PhD in medical and social psychology at theUniversity of California, Los Angeles.

David Naylor, MD, DPhil, isPresident of the University ofToronto, a position he has heldsince 2005, after leading theUniversity as the Dean ofMedicine for the previous sixyears. Previously, he was foundingchief executive officer of the

Institute for Clinical Evaluative Sciences from1991 to 1998. Dr. Naylor is internationallyrecognized as a leader in health servicesresearch and evidence-based health and socialpolicy. He has advised a number ofgovernments on policy issues over the last 15years and served as chair of the NationalAdvisory Committee on SARS and PublicHealth in 2003. He holds degrees from Toronto(MD) and Oxford (DPhil), where he studied as aRhodes Scholar. Dr. Naylor is the co-author ofapproximately 300 scholarly publications,spanning social history, public policy,epidemiology, and health economics, as well asclinical and health services research in mostfields of medicine. He has received national andinternational awards for research and academicleadership. He is a Fellow of the Royal Societyof Canada and the Canadian Academy of

Health Sciences, a Foreign Associate Fellow ofthe US Institute of Medicine, and an Officer ofthe Order of Canada.

Ariel Pablos-Méndez, MD, MPH, isManaging Director of theRockefeller Foundation, and aProfessor of Clinical Medicine andPublic Health at ColumbiaUniversity. He was previouslyDirector of KnowledgeManagement and Sharing at the

World Health Organization (WHO), where heworked to bridge the know-do gap in publichealth. Earlier at the Rockefeller Foundation(1998-2004), he created several public-privatepartnerships to develop drugs and vaccines fordiseases of poverty, led a re-thinking of theFoundation's program on AIDS treatment inAfrica, and managed the Joint LearningInitiative on Human Resources for Health. TheFoundation’s efforts in global health arecurrently dedicated to the transformation ofhealth systems towards universal healthcoverage. Dr. Pablos-Méndez received his MDfrom the University of Guadalajara’s School ofMedicine (Mexico) and his MPH from ColumbiaUniversity, where he also serves as a Professorof Clinical Medicine and Public Health.

K. Srinath Reddy, MD, DM, isPresident of the Public HealthFoundation of India and untilrecently headed the Departmentof Cardiology at All India Instituteof Medical Sciences. Havingtrained in cardiology andepidemiology, Dr. Reddy has been

involved in several major international andnational research studies, including theINTERSALT global study of blood pressure andelectrolytes and INTERHEART global study onrisk factors of myocardial infarction. He is Chairof the Initiative for Cardiovascular HealthResearch in the Developing Countries, Chair ofthe Foundations Advisory Board of the WorldHeart Federation, and has served on manyWHO expert panels. He edited the National

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Medical Journal of India for 10 years and hasmore than 250 scientific publications ininternational and Indian peer-reviewedjournals. Dr. Reddy has received numerousawards, including the WHO Director General’sAward for Global Leadership in TobaccoControl (2003), the prestigious PADMABHUSHAN by the President of India (2005), theQueen Elizabeth Medal (2005), and the LutherTerry Award for outstanding leadership intobacco control from the American CancerSociety. He was elected Foreign AssociateMember of the Institute of Medicine in 2004and was recently appointed President of theNational Board of Examinations in India.

Susan C. Scrimshaw, PhD, isPresident of the Sage Colleges.Her past leadership positionsinclude President of SimmonsCollege, Dean of the School ofPublic Health and Professor ofCommunity Health Sciences andAnthropology at the University of

Illinois at Chicago, and Associate Dean of PublicHealth and Professor of Public Health andAnthropology at the University of California atLos Angeles. Dr. Scrimshaw obtained her MAand PhD in anthropology from ColumbiaUniversity, where she was a student of MargaretMead. Her research includes communityparticipatory research methods, addressinghealth disparities, improving pregnancyoutcomes, violence prevention, health literacy,and culturally appropriate delivery of healthcare. Nationally, Dr. Scrimshaw is a AAASFellow and a member of the Institute ofMedicine where she has served on theGoverning Council, the Committee onCommunication for Behavior Change:Improving the Health of Diverse Populations,the Committee on Health Literacy, and theCommittee on Science, Engineering and PublicPolicy. Internationally, she has served asPresident of the Board of Directors of the U.S.-Mexico Foundation for Science. Her manyawards include the Margaret Mead Award fromthe American Anthropological Association and

the Society for Applied Anthropology and, forher work on the health of Latino populations, agold medal from former President Vicente Foxof Mexico. Dr. Scrimshaw was raised inGuatemala until age 16.

Jaime Sepulveda, MD, MPH, DSc, isa Senior Fellow and Director ofSpecial Initiatives in GlobalHealth for the Bill & MelindaGates Foundation. Dr. Sepulvedaworks closely with key foundationpartners—including the GAVIAlliance, where he chairs the

Executive Committee—to increase access tovaccines and other effective health solutions indeveloping countries. He was formerly Directorof Integrated Health Solutions Development atthe foundation. Dr. Sepulveda served for morethan 20 years in a variety of senior health postsin the Mexican government. He was Director ofthe National Institutes of Health of Mexico from2003 to 2006, Vice-Minister of Health, Director-General of Mexico’s National Institute of PublicHealth, and Dean of the National School ofPublic Health. In addition to his researchcredentials, Dr. Sepulveda is an experiencedimplementer of effective health programs, suchas Mexico’s Universal Vaccination Program,which eliminated polio, measles, anddiphtheria. He also designed a national healthinformation system and founded Mexico’sNational AIDS Council. His medical degree isfrom National Autonomous University ofMexico and he has three advanced degrees fromthe Harvard School of Public Health.

David Serwadda, MBChB, MSc,MMed, MPH, is Professor of PublicHealth and former Dean of theMakerere University School ofPublic Health (MUSPH) inUganda. He is also a foundingmember of Accordia GlobalHealth Foundation’s Academic

Alliance. Dr. Serwadda is an infectious diseaseepidemiologist, who in the early 1980s was oneof the first physicians in Uganda to recognize


Commissioner Biographiescontinued



the new disease that became known as AIDS.He has worked continuously on HIV-relatedresearch and prevention ever since. He receivedhis MBChB and MMed (Internal Medicine) fromMakerere University and an MPH from JohnsHopkins Bloomberg School of Public Health.He has been a senior investigator on the RakaiProgram since its inception in 1988, and is theUgandan principal investigator on the ongoingNIH-funded "Trial of Male Circumcision forHIV Prevention." He has been instrumental inthe scientific design and management of theproject and has provided critical liaison betweenthe project, the local community, Ugandanpolitical and policy decision makers, theUgandan Ministry of Health, and internationalagencies including UNAIDS, WHO, and theWorld Bank.

Professor Ke Yang is ExecutiveVice-president of PekingUniversity (PKU) and PekingUniversity Health Science Center(PKUHSC). She is also a memberof the 11th CPPCC nationalcommittee, the Academic DegreeCommittee of State Council, Vice-

president of China Medical Association, andmember of the Standing Committee of ChineseCommittee for Academic Degree andPostgraduate Education. For the past sevenyears, Professor Ke has been a passionate leaderin medical education reform. She has beenleading a successful curriculum reform thatemphasizes humanity, problems and practice(including primary practice). Her broad visionincludes promoting evidence based clinicalresearch, multidisciplinary cooperation, andinternationalizing both research and educationof PKU-HSC. She also plays an important rolein motivating University affiliated hospitals toactively participate in health system reform.Professor Ke is a productive researcher in cancerstudy. Her major area of research is on theenvironmental and genetic factors of upper

digestive tract malignant tumor. As a Professorand Director of the genetics laboratory, herfocus is on the HPV virus and its associationwith human cancers. Professor Ke haspublished more than 80 articles on cancerresearch and on medical education and healthmanagement, with a total citation of over 1000.She has been the advisor of more than 40graduate students and respectively been grantedfour Chinese patents and two internationalpatents.

Huda Zurayk, PhD, a Lebanesebiostatistician, was Dean of theFaculty of Health Sciences at theAmerican University of Beirutfrom 1998-2008. Dr. Zurayk’spublic health research focuses onthe social determinants ofpopulation health, reproductive

health, and women's health. From 1987–98, she was Senior Representative and then SeniorResearch Associate at the Population CouncilRegional Office for West Asia and North Africa.Just after joining the Population Council inCairo, she co-founded the RegionalReproductive Health Working Group, a networkof researchers throughout the region, notablefor producing the landmark Giza Study onwomen, reproduction, and health in rural Egypt.Dr. Zurayk served on the Reproductive HealthPanel of the U.S. National Academy of Sciencesfrom 1994-95 and two terms as an electedmember of the Council of the InternationalUnion for the Scientific Study of Populationfrom 1993-2002. She was also a member of theInternational Scientific Advisory Board of theAfrica Centre for Health and Population Studiesin South Africa and served on the Women andGender EquityKnowledge Network of theWHO Commission on Social Determinants ofHealth. Her PhD in biostatistics is from JohnsHopkins University and her master’s in statisticsis from Harvard University.

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DAY ONE

Opening RemarksSteven E. Hyman, MD is Provost ofHarvard University and Professorof Neurobiology at HarvardMedical School. From 1996 to2001, he served as Director of theNational Institute of MentalHealth (NIMH). Before that Dr.Hyman was Professor of

Psychiatry at Harvard Medical School, Directorof Psychiatry Research at MassachusettsGeneral Hospital, and the first faculty Directorof Harvard University's Mind, Brain, andBehavior Initiative. In the laboratory he studiedthe molecular biology of neurotransmitteraction. Dr. Hyman is a member of the Instituteof Medicine of the National Academy ofSciences and of the American Academy of Artsand Sciences. He currently serves as Editor ofthe Annual Review of Neuroscience.

Jeffrey S. Flier, MD is the 21stDean of the Faculty of Medicine atHarvard University, appointed onSeptember 1, 2007. Dr. Flier, anendocrinologist and an authorityon the molecular causes of obesityand diabetes, is also the CarolineShields Walker Professor of

Medicine at Harvard Medical School. Previouslyhe had served as Harvard Medical SchoolFaculty Dean for Academic Programs and ChiefAcademic Officer for Beth Israel DeaconessMedical Center, a Harvard teaching affiliate. Dr.Flier is a fellow of the Institute of Medicine ofthe National Academy of Sciences, theAmerican Association for the Advancement ofScience, and of the American Academy of Artsand Sciences.

Margaret Chan, MD (videoremarks) is Director-General ofthe World Health Organization(WHO), appointed in November2006. Previously Dr. Chan wasWHO Assistant Director-Generalfor Communicable Diseases aswell as Representative of the

Director-General for Pandemic Influenza. Priorto joining WHO, she was Director of Health inHong Kong. During her nine-year tenure, Dr.Chan confronted the first human outbreak ofH5N1 avian influenza in 1997. She successfullydefeated the spate of severe acute respiratorysyndrome (SARS) in Hong Kong in 2003. Shealso launched new services to prevent diseaseand promote better health.

Irina Bokova, MBA (video remarks)is the Director-General ofUNESCO. She was previouslyAmbassador of the Republic ofBulgaria to France and Monaco,Personal Representative of theBulgarian President to the"Organisation Internationale de la

Francophonie," and Permanent Delegate toUNESCO from 2005 to 2009. She obtained anMBA from the Moscow State Institute ofInternational Relations and studied at theuniversities of Maryland and Harvard in theUSA. During her long and distinguished career,she also served as Bulgaria's representative tothe United Nations and as her country'sSecretary of State for European integration andForeign Minister. Ms. Bokova has longpromoted the transition to Europeanintegration. As Founder and Chairperson of theEuropean Policy Forum, she worked toovercome divisions in Europe and promote thevalues of dialogue, diversity, human dignity and rights.


Speaker and Panelists Biographies


Cheryl Scott is Senior Advisor forthe� Bill & Melinda GatesFoundation’sGlobal Health Program, providingstrategy counsel and support in itswork to ensure that vaccines andother health solutions reach thepeople who need them the most.

Ms. Scott was previously President and CEO foreight years of the Seattle-based Group HealthCooperative, one of the oldest and mostrespected integrated health-care systems in theU.S. In her 25 years there, she also served asExecutive Vice President and Chief OperatingOfficer. In 2005, the University of Washingtonand Group Health created the Cheryl M.Scott/Group Health Cooperative Professorshipin Health Care Leadership in the School ofPublic Health in recognition of hercontributions.

Ariel Pablos-Méndez, MD, MPH, isManaging Director of theRockefeller Foundation, and aProfessor of Clinical Medicine andPublic Health at ColumbiaUniversity. He was previouslyDirector of KnowledgeManagement and Sharing at the

World Health Organization (WHO), where heworked to bridge the know-do gap in publichealth. Earlier at the Rockefeller Foundation, hecreated several public-private partnerships todevelop drugs and vaccines for diseases ofpoverty, led a re-thinking of the Foundation'sprogram on AIDS treatment in Africa, andmanaged the Joint Learning Initiative onHuman Resources for Health. The Foundation’sefforts in global health are currently dedicatedto the transformation of health systems towardsuniversal health coverage. Dr. Pablos-Méndez isa member of the Commission on the Educationof Health Professionals for the 21st Century. Hiscomplete bio is listed within the Commissionerssection.

Report Presentation andDiscussionpresented by the Launch Co-Chairs

Richard Horton, FRCP, FMedSci, isEditor-in-Chief of The Lancet. Dr.Horton is an honorary Professor atthe London School of Hygieneand Tropical Medicine, UniversityCollege London, and theUniversity of Edinburgh. He is aCouncil member of the UK’s

Academy of Medical Sciences and theUniversity of Birmingham, and he chairs theBoard of the Health Metrics Network. He has astrong interest in issues of global health andmedicine’s contribution to wider culture. Hiscomplete bio is listed within the Commissionerssection.

Lincoln Chen, MD, MPH, isPresident of the China MedicalBoard (CMB), an independentAmerican foundation endowed byJohn D. Rockefeller to advancehealth in China and Asia bystrengthening medical education,research and policies.

Dr. Chen was the Founding Director of theHarvard Global Equity Initiative (2001-2006)and from 1987-1996, the Taro Takemi Professorof International Health and Director of theUniversity-wide Harvard Center for Populationand Development Studies. From 1997-2001, hewas Executive Vice-President of the RockefellerFoundation, and earlier for 14 years, representedthe Ford Foundation in India and Bangladesh.His complete bio is listed within theCommissioners section.

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Julio Frenk, MD, MPH, PhD, is Deanand T & G AngelopoulosProfessor of Public Health andInternational Development at theHarvard School of Public Health.Dr. Frenk was the Minister ofHealth of Mexico from 2000 to2006, where he pursued an

ambitious agenda to reform the nation’s healthsystem. He was also the founding Director-General of the National Institute of PublicHealth in Mexico. From 1998-2000, he wasExecutive Director in charge of Evidence andInformation for Policy for the World HealthOrganization. Most recently, he was a SeniorFellow in the global health program of the Bill& Melinda Gates Foundation and President ofthe Carso Health Institute in Mexico City. Hiscomplete bio is listed within the Commissionerssection.

Panel 1: Transforming theLearning ProcessChair:

David Naylor, MD, DPhil, isPresident of the University ofToronto, a position he has heldsince 2005, after leading theUniversity as the Dean ofMedicine for the previous sixyears. Previously, he was foundingChief Executive Officer of the

Institute for Clinical Evaluative Sciences from1991 to 1998. Dr. Naylor is internationallyrecognized as a leader in health servicesresearch and evidence-based health and socialpolicy. He has advised a number ofgovernments on policy issues over the last 15years and served as Chair of the NationalAdvisory Committee on SARS and PublicHealth in 2003. Dr. Naylor is a member of theCommission on the Education of HealthProfessionals for the 21st Century. His completebio is listed within the Commissioners section.

David Serwadda, MBChB, MSc,MMed, MPH, is Professor of PublicHealth and former Dean of theMakerere University School ofPublic Health (MUSPH) inUganda. He is also a foundingmember of Accordia GlobalHealth Foundation’s Academic

Alliance. Dr. Serwadda is an infectious diseaseepidemiologist, who in the early 1980s was oneof the first physicians in Uganda to recognizethe new disease that became known as AIDS.He has worked continuously on HIV-relatedresearch and prevention ever since. Dr.Serwadda is a member of the Commission onthe Education of Health Professionals for the21st Century. His complete bio is listed withinthe Commissioners section.

Afaf I. Meleis, PhD, is the MargaretBond Simon Dean of Nursing atthe University of PennsylvaniaSchool of Nursing, Professor ofNursing and Sociology, andDirector of the school's WHOCollaborating Center for Nursingand Midwifery Leadership. Prior to

coming to Penn, she was a Professor on thefaculty at the University of California LosAngeles and the University of California SanFrancisco for 34 years. Dr. Meleis' researchfocuses on global health, immigrant andinternational health, women's health, and onthe theoretical development of the nursingdiscipline. Dr. Meleis is a member of theCommission on the Education of HealthProfessionals for the 21st Century. Her completebio is listed within the Commissioners section.

Joseph Kolars, MD, is SeniorAssociate Dean of Education andGlobal Initiatives and Professor ofInternal Medicine at University ofMichigan Medical School. Heserves as the medical school’s leadfor the oversight and expansion ofboth its educational mission and

its global initiatives. A gastroenterologist, Dr.Kolars was previously at the Mayo Clinic. Since


Speaker and Panelists Biographiescontinued


late 2007, he divided his time between the MayoClinic and the Bill and Melinda GatesFoundation, where he continues to work oneducation systems that build human resourcecapacity to transform health. Dr. Kolars hasfocused his career on physician education andhas held a number of leadership roles ineducation programs for medical students,residents, and fellows. His scholarship haslargely emphasized educational outcomes,measurements of competency, facultydevelopment, and effective learning venues.

Panel 2: ReformingEducational InstitutionsChair:

Huda Zurayk, PhD, was Dean ofthe Faculty of Health Sciences atthe American University of Beirutin Lebanon from 1998-2008. Dr.Zurayk’s public health researchfocuses on the social determinantsof population health, reproductivehealth, and women's health. From

1987 to 1998, she was Senior Representativeand then Senior Research Associate at thePopulation Council Regional Office for WestAsia and North Africa. She served on theReproductive Health Panel of the U.S. NationalAcademy of Sciences, the Council of theInternational Union for the Scientific Study ofPopulation, the International Scientific AdvisoryBoard of the Africa Centre for Health andPopulation Studies, and the Women and GenderEquityKnowledge Network of the WHOCommission on Social Determinants of Health.Dr. Zurayk is a member of the Commission onthe Education of Health Professionals for the21st Century. Her complete bio is listed withinthe Commissioners section.

Panelists:

Jordan J. Cohen, MD, is Professorof Medicine and Public Health atGeorge Washington Universityand President Emeritus of theAssociation of American MedicalColleges (AAMC). Dr. Cohenspent 40 years in academicmedicine at some of the nation's

most prestigious institutions. He was Dean ofthe medical school and Professor of Medicine atthe State University of New York at Stony Brookand President of the medical staff at UniversityHospital. Prior to that, he was Professor andAssociate Chairman of Medicine at theUniversity of Chicago-Pritzker School ofMedicine, and Physician-in-chief and Chairmanof the Department of Medicine at the MichaelReese Hospital and Medical Center. Dr. Cohenis a member of the Commission on theEducation of Health Professionals for the 21stCentury. His complete bio is listed within theCommissioners section.

Susan C. Scrimshaw, PhD, isPresident of the SageColleges.�Her past leadershippositions include President ofSimmons College, Dean of theSchool of Public Health andProfessor of Community HealthSciences and Anthropology at the

University of Illinois at Chicago, and AssociateDean of Public Health and Professor of PublicHealth and Anthropology at the University ofCalifornia at Los Angeles. Her research includescommunity participatory research methods,addressing health disparities, improvingpregnancy outcomes, violence prevention,health literacy, and culturally appropriatedelivery of health care. Dr. Scrimshaw is amember of the Commission on the Education ofHealth Professionals for the 21st Century. Hercomplete bio is listed within the Commissionerssection.

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Jane Henney, MD, is Professor ofMedicine and Public HealthScience in the College of Medicineat the University of Cincinnati.Until 2008, she was Senior VicePresident and Provost for HealthAffairs at the University ofCincinnati Academic Health

Center. She was the first woman to be namedCommissioner of the U.S. Food and DrugAdministration, a position she held from 1998-2001. For the past 20 years, Dr. Henney hasserved in a series of senior health-policyleadership positions. She was deputy director ofthe National Cancer Institute from 1980-85, ViceChancellor of Health Programs and thenInterim Dean of the University of KansasMedical Center, and Vice President for HealthSciences at the University of New Mexico. Sheserves on a variety of boards of directors in thehealth care field, including the CommonwealthFund and the China Medical Board.

Celebratory Dinner Speaker:

Samuel O. Thier, MD, is Professor ofMedicine and Health Care Policy,Emeritus at Harvard MedicalSchool. He had been Professor ofMedicine and Professor of HealthCare Policy at Harvard MedicalSchool from 1994-2007.Previously he was President and

Chief Executive Officer of Partners HealthCareSystem, President of The MassachusettsGeneral Hospital, and Brandeis University’sPresident. He served as President of theInstitute of Medicine, National Academy ofSciences and as Chairman of the Department ofInternal Medicine at Yale University School ofMedicine, where he was the Sterling Professor.Dr. Thier is an authority on internal medicineand kidney disease and is also known for hisexpertise in national health policy, medicaleducation, and biomedical research.

Panel 3: Local Adaptabilityin a Global WorldChair:

Nigel Crisp, KCB, is anindependent crossbench memberof the House of Lords and worksmainly on internationaldevelopment and global health.From 2000 to 2006, he was bothChief Executive of the NHS, thelargest health organization in the

world, and Permanent Secretary of the UKDepartment of Health, and led major reforms inthe English health system. In 2007 he co-chaired an international Task Force onincreasing the education and training of healthworkers globally and subsequently founded theZambia UK Health Workforce Alliance in 2009to implement some of the Task Forcerecommendations. Lord Crisp is a member ofthe Commission on the Education of HealthProfessionals for the 21st Century. His completebio is listed within the Commissioners section.

Panelists:

Timothy Evans, MD, DPhil, ofCanada, is currently the AssistantDirector-General for Information,Evidence and Research at theWorld Health Organization. From2003 to 2007, he served as theAssistant Director-General forEvidence and Information for

Policy. From 1997 to 2003, Dr. Evans wasDirector of Health Equity at the RockefellerFoundation. Dr. Evans is a member of theCommission on the Education of HealthProfessionals for the 21st Century. His completebio is listed within the Commissioners section.




Patricia Garcia, MD, MPH, isProfessor of the School of PublicHealth at Cayetano HerediaUniversity (UPCH) and formerChief of the Peruvian NationalInstitute of Health (2006-2008).She has worked at the NationalSTD/AIDS Program in Peru, as

Director of the Epidemiology, STD and HIVUnit at UPCH, and as Vice Dean of Research atUPCH. She was a member of the SeniorTechnical Advisor Group of the ReproductiveHealth Department at the World HealthOrganization and Chair of the WHO HPVExpert Advisory Group. She is actively involvedin research on STIs and HIV, global health, andinformatics. Dr. Garcia is a member of theCommission on the Education of HealthProfessionals for the 21st Century. Her completebio is listed within the Commissioners section.

Barry Kistnasamy, MBChB,MMed,is Executive Director of theNational Institute forOccupational Health (NIOH) andthe National Cancer Registry(NCR) in South Africa. Dr.Kistnasamy was the former Deanof Medicine of the Nelson R.

Mandela School of Medicine of the Universityof KwaZulu-Natal in Durban, South Africa andfrom 1995 to 2000 was Deputy Director Generalof the Department of Health, Welfare andEnvironment in the Northern Cape province.His experience encompasses strategic andoperational planning and translation of healthpolicy into action. Dr. Kistnasamy is a memberof the Commission on the Education of HealthProfessionals for the 21st Century. His completebio is listed within the Commissioners section.

Panel 4: Strategies forDisseminationChair:

Harvey V. Fineberg, MD, PhD, isPresident of the Institute ofMedicine. He previously servedHarvard University as Provost and13 years as Dean of the School ofPublic Health. He helped foundand served as President of theSociety for Medical Decision

Making and is a consultant to the World HealthOrganization. His research has includedassessment of medical technology, evaluation ofvaccines, and dissemination of medicalinnovations. At the Institute of Medicine, he haschaired and served on a number of panelsdealing with health policy issues, ranging fromAIDS to new medical technology. Dr. Finebergis a member of the Commission on theEducation of Health Professionals for the 21stCentury. His complete bio is listed within theCommissioners section.

Panelists:

Manuel M. Dayrit, MD, MSc, headsthe World Health Organization’sHuman Resources for HealthDepartment in providing globalguidance and support to countriesfor developing a sustainablehealth workforce. Scaling up theeducation of health workers

towards their equitable distribution andeffective performance are critical concerns. Theadoption of the WHO Global Code of Practiceon the International Recruitment of HealthPersonnel during the May 2010 World HealthAssembly was a milestone in global publichealth to which Dr. Dayrit and the HRH

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Department contributed significantly. Dr. Dayritwas Secretary of Health (Minister) of thePhilippines (2001-2005). He completed medicaland public health studies at the University ofthe Philippines and the London School ofHygiene and Tropical Medicine.

George E. Thibault, MD, ispresident of the Josiah Macy, Jr.Foundation. Prior to that he wasVice President of Clinical Affairs atPartners Healthcare System inBoston and Director of theAcademy at Harvard MedicalSchool. He was the first Daniel D.

Federman Professor of Medicine and MedicalEducation at HMS and is now the FedermanProfessor, Emeritus. He previously served asChief Medical Officer at Brigham and Women’sHospital and as Chief of Medicine at theHarvard-affiliated Brockton/West Roxbury VAHospital. He was Associate Chief of Medicineand Director of the Internal Medical ResidencyProgram at Massachusetts General Hospital.For nearly four decades at HMS, Dr. Thibaultplayed leadership roles in medical education,including a central role in the New PathwayCurriculum reform and Integrated Curriculumreform.

Sigrun Møgedal, MD, DTM&H, isthe Chair of the Board for theGlobal Health Workforce Allianceand serves as a Special Adviser tothe Executive Director ofUNAIDS. A former NorwegianAmbassador for HIV/AIDS andGlobal Health Initiatives, Dr.

Møgedal’s main areas of professionalinvolvement are in the interface betweendevelopment, health and foreign policy, with afocus on governance for health at global andnational level. She has a long time involvementin human resources for health, and in workingwith civil society and community responses.From 2000-2001 she was a State Secretary inthe Ministry of Foreign Affairs in Norway.

Roger I. Glass, M.D., Ph.D., isDirector of the FogartyInternational Center andAssociate Director forInternational Research at theNational Institutes of Health. Hejoined the Centers for DiseaseControl and Prevention in 1977 as

a medical officer assigned to the EnvironmentalHazards Branch, was a scientist at theInternational Center for Diarrheal DiseaseResearch in Bangladesh from 1979 to1983, andin 1984, joined the National Institutes of HealthLaboratory of Infectious Diseases, where heworked on the molecular biology of rotavirus. In1986, Dr. Glass returned to the CDC to becomeChief of the Viral Gastroenteritis Unit at theNational Center for Infectious Diseases. He hasmaintained field studies in India, Bangladesh,Brazil, Mexico, Israel, Russia, Vietnam, Chinaand elsewhere. His research includesepidemiologic studies targeted to anticipate theintroduction of rotavirus vaccines.

Ariel Pablos-Méndez, MD, MPH, isManaging Director of theRockefeller Foundation and is aCommissioner on the Educationof Health Professionals for the21st Century. His complete bio islisted within Commisionerssection.

Closing Remarks:Julio Frenk, MD, MPH, PhD, Dean of the HarvardSchool of Public Health

Lincoln Chen, MD, MPH, President of the ChinaMedical Board

Complete bios for Dean Frenk and Dr. Chen withinthe Co-Chairs Bios section.




29


Anshu Abhat Harvard School of Public Health Priya Agrawal WHO Safe Childbirth Checklist ProgramSudhir Anand St. Catherine's College, Oxford UniversityVanessa Apea Harvard School of Public Health Diane Arathuzik Emmanuel CollegeDavid Arond Harvard School of Public Health Tamara Awerbuch Harvard School of Public Health Nadiah Baghdadi Northeastern UniversityJudy Beal Simmons College School of Health Sciences David Benton Inernational Council of NursesAnita Berlin UCL School of Life and Medical Sciences Zulfiqar Bhutta Aga Khan University Barry Bloom Harvard School of Public Health Brea Bondi-Boyd Contra Costa Regional Medical CenterAmanda Brewster Harvard Institute for Global HealthSteffanie Bristol Harvard School of Public HealthMarah Brown Harvard School of Public Health Kristin Brown Harvard School of Public HealthMary Brown Bullock Emory University and China Medical BoardJesse Bump Harvard School of Public HealthKathy Cahill The Bill & Melinda Gates FoundationFrancisco Campos Global Health Workforce AllianceMarie Castelli Harvard School of Public Health Arachu Castro Harvard Medical School Margaret Chan World Health OrganizationLincoln Chen China Medical BoardElizabeth Chen NE College of OptometryWanicha Chuekongkaew Siriraj Hospital, Mahidol UniversityMark Clapp Harvard School of Public Health Jordan Cohen George Washington UniversityElizabeth Cole Brigham Women's HospitalNigel Crisp House of LordsLe Cu Linh Hanoi School of Public HealthKarla Damus Northeastern University School of NursingPran Gopal Datta Bangabandhu Sheikh Mujib Medical University Manuel Dayrit World Health OrganizationDavid de Ferranti Harvard School of Public HealthRamesh C. Deka All India Institute of Medical SciencesRaymond Deng Harvard School of Public Health Karen Devereaux Melillo University of Massachusetts LowellZhe Dong Peking University Health Sciences CenterBruce Donoff Harvard School of Dental MedicineTim Evans Information Evidence and Research, WHOApril Edrington Harvard School of Public HealthVictoria Fan Harvard School of Public Health Mansour Farahani Harvard School of Public Health Harvey Fineberg US Institute of MedicineJeffrey S. Flier Harvard Medical SchoolPhyllis Freeman University of Massachusetts BostonJulio Frenk Harvard School of Public Health Patricia García Cayetano Heredia University, Peru Susan Gennaro Boston College William F. Connell School of NursingMichelle Giuliana Harvard School of Public HealthRoger Glass NIH Fogarty CenterCheong Hian Goh University of IllinoisJennifer Goldsmith Partners HC SystemAndrew Goldstein Harvard School of Public Health Sue Goldie Harvard School of Public Health and Harvard University

Symposium Attendees 2 8


Marise Gottlieb Endeavor CorporationMichael Grusby Harvard School of Public Health Saipin Hathirat Mahidol UniversityCecil Haverkamp Harvard School of Public Health Aditi Hazra Harvard School of Public Health Robert Hecht Results for Development InstituteJane Henney University of CincinnatiKatherine Herz Harvard School of Public Health John Hill World Medical AssociationJoan Holloway International Association of Physicians in AIDS CareWilliam Holzemer Rutgers UniversityRichard Horton The Lancet William Hsiao Harvard School of Public Health John Hsu Mongan InstituteJose Humphreys Optimum Health ClinicDavid Hunter Harvard School of Public Health Sharon Huttly London School of Hygiene & Tropical MedicineSteven Hyman Harvard UniversityPaula Ivey Henry Harvard School of Public Health Elizabeth Jackson Harvard School of Public Health Marian Jacobs University of Cape Town, South AfricaIny Jhun Harvard School of Public Health Edward Kakungulu Gulu University, UgandaNancy Kane Harvard School of Public Health Phyllis Kanki Harvard School of Public Health Patrick Kelley Institute of Medicine of the US National AcademiesCarole Kenner Northeastern University Bouvé College of Health SciencesEric L. Keuffel The Fox School of Business, Temple UniversityMohamed Ismail Khan Dhaka Medical College Tamera Kingston Harvard School of Public HealthBarry Kistnasamy National Insitute for Occupational Health Felicia Knaul Harvard Medical School Joe Kolars University of Michigan David Korn Harvard Medical SchoolJoel Lamstein John Snow, Inc.Ana Langer Harvard School of Public HealthIan Lapp Mailman School of Public Health,Columbia UniversityLaurie Lauzon Clabo Massachusetts General Hospital Aaron Lawson University of Ghana Medical SchoolAnh Vu Le Hanoi School of Public HealthThuy-Tien Le Tufts University School of MedicineJennifer Leaning FXB Center for Health and Human RightsChenhui Liu Harvard School of Public Health,China Medical BoardTserenkhuugyin Llkagvasuren Mongolia Health Sciences UniversityFabiola León-Velarde Cayetano Heredia University, PeruClifford Lo Harvard Medical SchoolRobyn Long Harvard School of Public HealthPisake Lumbiganon Khon Kaen UniversityLe Anh Vu Harvard Medical School Ruth Malone Harvard School of Public HealthWilliam Mann US NavyTori Manuelli Harvard School of Public HealthAnne Margulies Harvard University Bethany Maylone Harvard School of Public HealthLinda McDonald Harvard School of Public HealthAfaf Meleis University of Pennsylvania School of NursingKaren Devereaux University of Massachusetts-Lowell

Symposium Attendees



313 0

Catherine Michaud Harvard School of Public Health, China Medical BoardYanan Mo Harvard School of Public HealthSigrun Møgedal Global Health Workforce Alliance and UNAIDSLilah Moore Global Health ConsultantFitzhugh S. M. Mullan George Washington UniversityAlbert Mulley, Jr. Massachusetts General HospitalLee Nadler Harvard Medical SchoolRuvandhi Nathavitharana Harvard School of Public Health, China Medical BoardDavid Naylor University of TorontoAndre-Jaques Neusy Health Equity NetworkStanislava Nikolova Harvard School of Public HealthJohn Norcini FAIMERSumberzul Nyamjav Health Sciences University of MongoliaAriel Pablos-Méndez Rockefeller Foundation Natalia Palacios Harvard School of Public HealthBjörg Pálsdóttir Health Equity NetworkTess Panizales Center for Surgery and Public Health, BWUTricia Penniecook Loma Linda University School of Public HealthSophia Qiu Harvard School of Public HealthEstelle Quain USAIDRayapu Ramesh BOSS & CIPCA Danae Roumis Harvard School of Public HealthJulia Royall US National Library of MedicineCheryl Scott The Bill & Melinda Gates Foundation Susan Scrimshaw The Sage Colleges David Serwadda Makerere University School of Public HealthJulie Shample Harvard School of Public HealthPengjian Shi Ministry of Education of ChinaKenji Shibuya University of TokyoMiles Shore Harvard Medical SchoolEleanor Shore Harvard Medical SchoolSonya Soni Harvard School of Public HealthHarrison Spencer Association of Schools of Public Health Ellie Starr Harvard School of Public Health Bill Stason Harvard School of Public HealthDavid T. Stern Mount Sinai School of MedicineAllan Stern The Sage CollegesBaozhi Sun China Medical UniversityGeorge Thibault Josiah Macy, Jr. FoundationSam Thier Massachusetts General Hospital, Harvard Medical School Katie Tiger Harvard School of Public HealthAlexander Tsai Harvard University Nancy Turnbull Harvard School of Public Health Sonali Vaid Harvard School of Public Health, China Medical BoardJudith Wasserheit University of WashingtonDebra Weinstein Partners HealthCare SystemLeana Wen Brigham and Women's Hospital/Massachusetts General HospitalNancy White Street Harvard School of Public HealthBen Williams Gunner TrainingMary Elizabeth Wilson Harvard School of Public Health Lydia Wlasiuk University of California, DavisBob Woollard University of British ColumbiaRandy Wykoff ETSU, College of Public HealthWai Ping Yau Harvard School of Public HealthChangzheng Yuan Harvard School of Public HealthStephen Zoloth Northeastern University Bouvé College of Health Sciences Huda Zurayk American University of Beirut

List reflects those registered by November 15, 2010.




© Harvard School of Public Health, 2010.

THE JOSEPH B. MARTIN CONFERENCE CENTER AT HARVARD MEDICAL SCHOOL

77 AVENUE LOUIS PASTEUR, BOSTON, MA

www.hsph.harvard.edu/healthprofessionals


hsph conference program 11/2010

Documents